Deep impact: The bad news about banging your head

Concussion has long been seen as a temporary and fairly harmless affliction. But the repercussions can last a lifetime

By Bob Holmes

THE two men in the hospital ward had both hit their heads in car accidents, but that was where the similarities ended. One would spend weeks unconscious in critical care, near to death. The other had only a mild concussion; he never lost consciousness, but somehow didn’t feel quite right.

Yet months later their roles were reversed. “The one with the severe injury is almost back to normal function,” says Douglas Smith, director of the Center for Brain Injury Repair at the University of Pennsylvania in Philadelphia, “and the one with concussion can’t go back to work, probably ever.”

Smith’s two patients illustrate one of the frustrating paradoxes of head injuries&colon; even seemingly mild impacts can have devastating long-term consequences. And we have no way of predicting who will fully recover and who will have lingering problems.

Concussion, or mild traumatic brain injury as doctors call it, has long been seen as a benign and temporary affliction. But over the past decade there has been growing realisation that longer-term symptoms can affect between 10 and 15 per cent of those diagnosed with it. These range from fuzzy thinking and memory lapses to, for the most unfortunate, serious neurological conditions such as premature Alzheimer’s disease.

In fact, concussion is thought to be the single biggest environmental cause of Alzheimer’s. Even a mild impact can double the risk of developing early dementia, according to a massive study of older military veterans in the US, which was presented at the Alzheimer’s Association International Conference in July (bit.ly/pDhlHJ). In that, the risk jumped from 7 to 15 per cent.

Concussion is thought to be the …

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